Obstetrical Challenges Of Grand Multipara- Experience From A Tertiary Care Centre

International Journal of Innovative Medicine and Health Science, Vol. 1: 1-5, 2013



Objective: To compare the obstetrical and neonatal complications among women who had previously delivered
five or more times (grand multiparous, GMP, Para5 and above) with those who had previously delivered one, two
and three times. (Multiparous, MP, para 1-3).
Design and setting: This prospective comparative study was conducted in the obstetrics and gynecology
department, NEIGRIHMS, Shillong, India.
Duration of study: one year and six months.
Material and methods: 162 grand multiparous women were compared with 338 multiparous women.
Results: Women with grand multiparity were significantly older than those with lower parity, more likely to be
unbooked and belonged to lower social class. Statistical significant difference was noted between the two groups
in terms of pregnancy induced hypertension, pre term labor, anemia and post partum hemorrhage. Anemia was
the commonest complication encountered (50% in grandmultiparous versus 26.33% in multiparous,p<0.0001).
Neonatal intensive care unit admissions, meconium stained amniotic fluid and perinatal mortality was higher in
grandmultiparous than multiparous. There was no significant difference between the two groups in terms of birth
asphyxia, congenital abnormality though a significant increase was found in terms of macrosomia in
Conclusion: Grand multiparity constitutes a high risk pregnancy particularly in areas with poor utilization of
antenatal care.
Key words: Grandmultipara, , Obstetric complications, neonatal complications